Provider Demographics
NPI:1710699343
Name:ENDEAVOR HOME CARE LLC
Entity Type:Organization
Organization Name:ENDEAVOR HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:TIPA
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:830-421-1672
Mailing Address - Street 1:PO BOX 6081
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78853-6081
Mailing Address - Country:US
Mailing Address - Phone:830-421-1672
Mailing Address - Fax:
Practice Address - Street 1:152 ZAMORA CIRCLE SUITE 6
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-7885
Practice Address - Country:US
Practice Address - Phone:830-421-1672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty